Course of molecular hemostatic markers during and after different surgical procedures

Siemens, Hans-Joachim G; Brueckner, Sabine; Hagelberg, Soehnke; Wagner, Thomas; Schmucker, P.

doi:10.1016/s0952-8180(99)00119-1

Cited by 33 publications

(49 citation statements)

References 35 publications

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“…In healthy individuals, PAI-1 is found at low levels in the plasma (5-10 ng/ml), but it is elevated significantly in a number of diseases, including atherosclerosis (2), deep vein thrombosis (3), and non-insulin dependent diabetes mellitus (4). PAI-1 stabilizes both arterial and venous thrombi, contributing, respectively, to coronary arterial occlusion in post-myocardial infarction (5) and venous thrombosis following post-operative recovery from orthopedic surgery (6). Plasma PAI-1 is also elevated in postmenopausal women, and has been proposed to contribute to the relative increased incidence of cardiovascular disease in this population (7).…”

mentioning

confidence: 99%

Mapping of a Conformational Epitope on Plasminogen Activator Inhibitor-1 by Random Mutagenesis

Gorlatova

Elokdah

Fan

et al. 2003

Journal of Biological Chemistry

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The mechanism for the conversion of plasminogen activator inhibitor-1 (PAI-1) from the active to the latent conformation is not well understood. Recently, a monoclonal antibody, 33B8, was described that rapidly converts PAI-1 to the latent conformation (Verhamme, I., Kvassman, J. O., Day, D., Debrock, S., Vleugels, N., Declerck, P. J., and Shore, J. D. (1999) J. Biol. Chem. 274, 17511-17517). In an attempt to understand this interaction, and more broadly to understand the mechanism of the natural transition of PAI-1 to the latent conformation, we have used random mutagenesis to identify the 33B8 epitope in PAI-1. This site involves at least 8 amino acids scattered over more than two-thirds of the linear sequence that form a compact epitope on the PAI-1 three-dimensional structure. Surface plasmon resonance studies indicate a high affinity interaction between latent PAI-1 and 33B8 that is ϳ100-fold higher than comparable binding to active PAI-1. Structural modeling results together with surface plasmon resonance analysis of parental and site-directed PAI-1 mutants with disrupted 33B8 binding suggest the existence of a specific PAI-1 intermediate structure that is stabilized by 33B8 binding. These analyses strongly suggest that this intermediate form of PAI-1 has a partial insertion of the reactive center loop into ␤-sheet A, and together, these data have significant implications for the general serpin mechanism of proteinase inhibition.

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mentioning

confidence: 99%

Mapping of a Conformational Epitope on Plasminogen Activator Inhibitor-1 by Random Mutagenesis

Gorlatova

Elokdah

Fan

et al. 2003

Journal of Biological Chemistry

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“…More stable intermediate and breakdown products are therefore used. We chose D-dimers from a wide panel of potential activation markers because it has been shown that this parameter displays the greatest changes during and after different surgical procedures [4]. Furthermore, the choice of D-dimers was based on their general availability and use in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…D-dimers as the final product of the fibrinolytic system showed a continuous increase during the intraoperative and postoperative courses, with the highest levels reached in the group which underwent total hip replacement, followed by the hemicolectomy and cholecystectomy groups. The last in line were the patients with thyroid resection, who showed the least elevated levels at all times, although their levels were found to be significantly elevated compared to normal subjects [4]. In contrast to the initial assumption that endoscopic cholecystectomy causes the least tissue trauma (and thus the least activation of the procoagulant system), it was found that even this minimally invasive operation provoked a considerable degree of traumatic injury during surgery.…”

Section: Discussionmentioning

confidence: 99%

“…However, these changes also occur in endoscopic operations with minimal tissue traumatization [4]. On the one hand, this state of activation is comparable to the hypercoagulable state observed in patients with deep vein thrombosis (DVT) and pulmonary thromboembolism (PE).…”

Section: Introductionmentioning

confidence: 99%

“…It has nevertheless been shown that D-dimers, a final product of the fibrinolytic system, display the greatest changes during and after different surgical procedures [4]. …”

Section: Introductionmentioning

confidence: 99%

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Serum Concentration of D-Dimers as a Marker of the Activation of the Fibrinolytic System in Patients Undergoing Bronchoscopic and Thoracoscopic Investigations

Schreiber

Knolle²,

Lüdicke³

et al. 2003

Respiration

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Background: Hypercoagulability is common even after minimally invasive surgical techniques and is pathogenetically linked to postoperative thrombotic and cardiac complications. The activation of the coagulation and fibrinolytic systems after bronchoscopic and thoracoscopic investigations has not yet been elucidated. Objective: The aim of our study was to evaluate whether bronchoscopic and thoracoscopic investigations activate the fibrinolytic system. Methods: This study assessed cross-linked fibrinogen degradation products (D-dimer) in 120 patients after bronchoscopy with and without biopsies and/or bronchoalveolar lavage and after thoracoscopy with biopsies of the parietal pleura. Results: Both bronchoscopy and thoracoscopy induced a minor but significant increase in D-dimers in most patients, reversible mostly within 24 h. In rare cases, distinct increases lasting at least 24 h occurred. Conclusions: The slight and temporary increase in serum D-dimers induced by bronchoscopy and thoracoscopy is nonsignificant in most patients; however, in some cases, the coagulation/fibrinolytic systems may become markedly activated.

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Coagulation Disorders and Surgery

Shropshire¹,

Brainard²

2023

Small Animal Soft Tissue Surgery

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Course of molecular hemostatic markers during and after different surgical procedures

Cited by 33 publications

References 35 publications

Mapping of a Conformational Epitope on Plasminogen Activator Inhibitor-1 by Random Mutagenesis

Mapping of a Conformational Epitope on Plasminogen Activator Inhibitor-1 by Random Mutagenesis

Serum Concentration of D-Dimers as a Marker of the Activation of the Fibrinolytic System in Patients Undergoing Bronchoscopic and Thoracoscopic Investigations

Coagulation Disorders and Surgery

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